Nevada Medicaid ABA and managed care plans
Nevada Medicaid has covered ABA since January 1, 2016, and the policy sits in Medicaid Services Manual Chapter 3700. A child needs an autism diagnosis (or another condition for which ABA is medically necessary), submitted on form FA-11F. Every service needs prior authorization except the assessment, which is allowed once every 180 days. Around 90 percent of members are in managed care, and each plan sets its own prior authorization process, so call the number on the back of your card.
- Five managed care plans deliver ABA: Anthem, CareSource, Health Plan of Nevada, Molina and SilverSummit.
- State-run fee-for-service covers people with disabilities and seniors, among others.
- If a prior authorization is denied, ask your plan for a fair hearing or appeal.